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Organization

PULMONARY MEDICINE CONSULTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIJO D SHUNTICH (CHIEF OPERATING OFFICER)
(330) 758-7575
Entity
Organization

Contact information

Practice address
925 TRAILWOOD DR, YOUNGSTOWN, OH 44512-5008
(330) 758-7575
(330) 758-1833
Mailing address
925 TRAILWOOD DR, YOUNGSTOWN, OH 44512-5008
(330) 758-7575
(330) 758-1833

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
207RP1001X
Pulmonary Disease Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0736538
OH
01
258785
BLACK LUNG
OH
01
34161789700
BWC
OH
Enumeration date
04/19/2007
Last updated
01/24/2012
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